<form id="add-form" class="form-horizontal" role="form" data-toggle="validator" method="POST" action="">

    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('User_id')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-user_id" data-rule="required" data-source="user/user/index" data-field="nickname" class="form-control selectpage" name="row[user_id]" type="text" value="">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Name')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-name" class="form-control" name="row[name]" type="text" value="">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Wangdianid')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-wangdianid" class="form-control" name="row[wangdianid]" type="number">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Gonghao')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-gonghao" class="form-control" name="row[gonghao]" type="text" value="">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Bumen')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-bumen" class="form-control" name="row[bumen]" type="text" value="">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Zhiwu')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-zhiwu" class="form-control" name="row[zhiwu]" type="text" value="">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Idcard')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-idcard" class="form-control" name="row[idcard]" type="text" value="">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Phone')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-phone" class="form-control" name="row[phone]" type="text" value="">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Chexing')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-chexing" class="form-control" name="row[chexing]" type="text" value="">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Address')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-address" class="form-control" name="row[address]" type="text" value="">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Ruzhiriqi')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-ruzhiriqi" class="form-control datetimepicker" data-date-format="YYYY-MM-DD" data-use-current="true" name="row[ruzhiriqi]" type="text" value="{:date('Y-m-d')}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Lizhiriqi')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-lizhiriqi" class="form-control datetimepicker" data-date-format="YYYY-MM-DD" data-use-current="true" name="row[lizhiriqi]" type="text" value="{:date('Y-m-d')}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Danganno')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-danganno" class="form-control" name="row[danganno]" type="text" value="">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Chulingzheng')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-chulingzheng" class="form-control datetimepicker" data-date-format="YYYY-MM-DD" data-use-current="true" name="row[chulingzheng]" type="text" value="{:date('Y-m-d')}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Youxiaoqi')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-youxiaoqi" class="form-control datetimepicker" data-date-format="YYYY-MM-DD" data-use-current="true" name="row[youxiaoqi]" type="text" value="{:date('Y-m-d')}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Yxq')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-yxq" class="form-control" name="row[yxq]" type="number">
        </div>
    </div>
    <div class="form-group layer-footer">
        <label class="control-label col-xs-12 col-sm-2"></label>
        <div class="col-xs-12 col-sm-8">
            <button type="submit" class="btn btn-success btn-embossed disabled">{:__('OK')}</button>
            <button type="reset" class="btn btn-default btn-embossed">{:__('Reset')}</button>
        </div>
    </div>
</form>
